Healthcare Provider Details

I. General information

NPI: 1124953716
Provider Name (Legal Business Name): PATRIOT FAMILY EYE CARE , O.D, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7221 MARINERS LANDING DR
FAYETTEVILLE NC
28306-7479
US

IV. Provider business mailing address

7221 MARINERS LANDING DR
FAYETTEVILLE NC
28306-7479
US

V. Phone/Fax

Practice location:
  • Phone: 910-826-0100
  • Fax: 910-826-0400
Mailing address:
  • Phone: 910-826-0100
  • Fax: 910-826-0400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: BRANDI CHAVIS BAKER
Title or Position: OPTOMETRIST
Credential: O.D.
Phone: 910-322-3026